Running Head: HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

Hillsborough Compared to the State of Florida

Bryan Trinh
University of South Florida College of Nursing

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

Hillsborough Compared to the State of Florida

If a person is born in the United States of American, they most likely were born in a
specific county within a state that they can call home. The county a person considers home can
have many strengths that make that county seem like the best county to that persons perspective.
But every county, no matter how great they may seem, also has its weaknesses. A county could
have an extraordinary socioeconomic structure and have a majority of their population are above
the poverty line, but this one ranking doesnt for example mean the countys population is
entirely healthy. For example this urban countys population could have a high percentage of
people with type 2 diabetes. No county is perfect but as future healthcare providers it will be our
jobs to improve the health of our individual counties to then better improve the well-being of our
state and then even the entire nation. For instance Hillsborough county Florida is a perfect
starting example.
Hillsborough County resides in the western state of Florida and consists of Tampa,
Brandon and Weschase, among other cities. It is an urban county that consists of roughly 1.3
million people. Hillsborough is ranked 28th in overall health in Florida. The largest employers of
Hillsborough County are the Hillsborough school districts, MacDill Airforce Base, and the
Hillsborough Country government respectively Key West Chamber of Commerce. (2010.) The
largest healthcare systems in Hillsborough County are Hospital Corporation of America, Baycare
Health Systems and Health Management Associates (Erickson, C. (2012.).. Hillsborough
Countys poverty level is roughly 15% and is lower when compared to Floridas 16.7%.
Hillsborough county records state that roughly 87% of people over the age of 25 have a high
school diploma compared to the states 85%. (County Health Rankings. (2016.). The increase
may be due to the multiple school districts and the large population of the University of South

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

Florida. According to the Hillsborough County Health Profile, about 1.2% of the population
greater than the age of five cannot speak English well or at all. Compared to the Floridas 11.7%
that does not seem high at all. This gap between the county and the state may also be due to large
amount of school districts that provide excellent education to the children of Hillsborough
County (County Health Rankings. (2016.).
According to the county health profile of Hillsborough, three strengths
Hillsborough County has over the state rankings are cancer screenings and prevalence, access to
healthcare coverage and cholesterol awareness. Compared to the overall state population 70% of
50 to 75 years of age have gotten a colorectal screening compared to the states 64.7%. 81% of
the population of Hillsborough County of health coverage compared to the 77% of the state and
81% of the population have had their cholesterol checked within the last 5 years over 79% of the
state (United States Census Bureau. (2015). The fact that heart disease and cancer are the two
leading causes of death in Hillsborough County it is vital that rating remain higher than the
states. The three weaknesses of Hillsborough County include prevalence of diabetes and
diabetes management, hypertension and hypertension control and obesity. All three of these
weaknesses can correlate with one another and while at the VA spinal cord injury outpatient
clinic, it can be seen that many of the veterans are overweight and diagnosed with hypertension
and type 2 diabetes. For example, 12.4% have diabetes compared to the states 11.2% and only
62.2% of those with diabetes get A1C testing done compared with the states 69.3%. Also 36.3%
have hypertension and only 78% of those with hypertension take medication for it, compared to
the states 34.6% that have hypertension and 79% that take medication. An astonishing 29% of
the population of Hillsborough County are obese compared to the 26.4% of the state and only
31% have a healthy body weight compared to the states 35% (United States Census Bureau.

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

(2015). With these statistics the prevalence of heart disease, stroke and cancer will increase, in
turn increasing the countys mortality rate.
As previously mentioned, the prevalence of obesity in the population of Hillsborough
compared to the state is increasing and in turn increase the percentage of the population with
uncontrolled diabetes and hypertension. It is a priority health issue to implement interventions to
prevent the increase prevalence of obesity in not only adulthood but now more frequently seen
childhood. Losing weight with a healthy diet and exercise is the number one way of reducing a
persons blood glucose and blood pressure. It is our job has healthcare providers to promote and
advocate for patients wellbeing.
The Determinants-of-Health Model is used to help determine what makes people healthy
and others unhealthy and how the data is used to create a society in which everyone has a chance
at a long and healthy life. The model develops objectives that determine the relationship between
human biology, health system, environment and lifestyle. (Harris K, Holden C, Chen M. (2010).
It discusses disease prevention and health promotion using an ecological approach of the
population that consists of interventions. For example with the priority health issue of obesity
within the Hillsborough County, the determinants-of-Health Model will look at what makes
obesity so prevalent. Human biology plays a key role; everyones body is different but a person
has a higher chance of developing obesity if their family members are also obese. Other factors
include, genetic diseases or abnormalities. Spinal cord injuries also affects diet and mobility
among various others that are seen frequently at hospitals such as the VA. The health system
within the community also plays a factor when it comes to the accessibility and affordability of
healthcare. Environment also plays a key role in how accessible fresh produce is for the
population. A community that has an environment that consists of many fast food chains make it

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

very convenient for people. Even if the previous determinants were perfect; prevalence of
obesity within a population comes down to the individual themselves. If a person refuses to
incorporate healthy lifestyle changes such as, exercise and diet, the person may still develop
obesity. It is a combination of determinates that dictates the improvement of health and disease
prevention.
It can be seen at the spinal cord outpatient clinic at the VA that obesity is prevalent among
many of the spinal cord injury patients that are either complete or incomplete and use classic or
electronic wheelchairs for mobility. Planning interventions begins with identifying the
population subgroup, which in this case are the veterans at the VA. Next the risk situation is the
risk of developing obesity among the patients and also managing patients that are already obese.
The populations most common characteristic in this case are that they are spinal cord injury
patients.
Beginning with primary prevention which is described as preventing the disease from
occurring by modifying behaviors and exposures that lead of to the development of the disease.
For example if a spinal cord injury patient has a family history of obesity, that person has an
increased probability of developing obesity as well. Education and counselling on healthy
lifestyles should begin and also setting up dietary counselling if the patient wishes. If the patient
is paralyzed, education should be implemented on exercises that patient can perform
independently or with help of a caregiver. It is important to strengthen muscles with at least
weight barring exercises to promote health and prevent complications such as fractures and
wound development. Weight loss will also relieve pressure on the body while sitting in the
wheelchair, thus helping prevent pressure sore formation. Most veterans are insured by the VA to
some degree and social work and healthcare providers can help get the patient the supplies they

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

need. For primary prevention, education and modification of lifestyles are key to preventing the
occurrence of the disease.
Secondary prevention of obesity consists of interventions that detect and treat preexisting
factors that could cause the disease to develop or progress. For example a spinal cord injury
patient at the VA may not be considered obese but could have hypertension and diabetes. These
diseases correlate with obesity if left uncontrolled. Blood pressures should be taken to determine
if the patient is hypertensive and HA1C screenings should be done to see if the person is also
diabetic. BMI testing should also be done to determine if the patient is overweight. If the patient
is paralyzed physical therapy along with diet consultations should be implemented. Treating the
underlying factors also with diet and exercise will prevent the progression of obesity. The
veterans are given supplies whenever they enter the outpatient clinic and healthcare providers
and social workers try to provide the patient with ample support with their needs at home, work
and healthcare facilities.
Tertiary prevention consists of management of the disease and preventing further
progression that could lead to end stage consequences. Monitoring treatments for obesity include
monitoring their weight, BMI, blood pressure and HA1C. Having these factors within normal
limits will management and even eliminate obesity among other factors the patient may be
diagnosed with. A spinal cord injury patient that is suffering from obesity will also be dealing
with the consequences of the extra weight. The extra weight can cause pressure sores and make
mobility in and out of the chair difficult. If the patient is obese and suffering from hypertension
and diabetes, the patient could develop heart failure and peripheral vascular disease respectively.
As mentioned above implanting interventions that consist of education, diet consultations and
daily exercise will promote weight loss and in turn reduce the occurrence of obesity and other

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

diseases that correlate with it. Education to family members of the patient may also reduce the
spread of obesity within the family and future family members.
Primary prevention of any disease should be at utmost importance. Preventing a disease
from ever occurring is guarantees a person will live a healthier and longer life. Using spinal cord
injury patients as an example; primarily preventing obesity in spinal cord patients will greatly
reduce the presence of pressure wounds, risk of cardiovascular disease and risk of diabetic
complications. Continuous education is key to preventing disease and a proposal for increasing
the available educational resources within healthcare clinics. During checkups and follow up
appointments education on diet, exercises and healthy lifestyle choices should be available for
patients. More frequent follow ups and screenings should be done as well. The healthcare
community, along with the county government should implement more community events that
promote exercise. For example more opportunities for 5k runs, charity walks, educational
seminars and community group activities that get the population to become more active. If
enough people demand the education on prevention of obesity, the government and healthcare
facilities will have to provide for their patients. The only opposing force would have to be the
patients themselves. If the patients do not want the education or change their own lifestyles;
healthcare providers cannot force it upon them. The first step towards presenting the health
policy proposal would have to be getting the word out. Giving presentations to the community
and setting up events to gather people around to offer education and benefits of healthy living.
The seminars would provide all the knowledge and education needed for the patients and answer
any and all questions. Starting with patients with spinal cord injuries would be a good start
because their disability increases their risk of developing obesity compared to patients able to
become active independently. If all the above are implemented and the patients are compliant in

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

improving their lifestyles then dramatic decreases in obesity should become present along with
decreases in many related co-morbidities. By decreasing the prevalence of obesity, the
populations health will be greatly enhanced.
In conclusion, there are multiple counties within a state and each county ranks differently
compared to one another and the state. Each county has differences in strengths and weaknesses
of their healthcare within their population, but improving the healthcare of their population is a
common goal. As mentioned one of the weaknesses in Hillsborough County, is the prevalence of
obesity compared to the state. A sub group that is greatly affected by obesity would have to be
spinal cord injury patients. It is crucial to implement primary prevention for these patients to
better improve their quality of life. Improving the quality of life is not only for spinal cord injury
patients, but for the population as a whole. Prevention is key and education and the choice to live
healthier lifestyles are the foundations of improving the healthcare of not only the county but the
state, the nation and even the world.

HILLSBOROUGH COMPARED TO THE STATE OF FLORIDA

References
County Health Rankings. (2016.) Country Health Rankings and Roadmaps. Retrieved March 9,
2016 from
http://www.countyhealthrankings.org/app/florida/2015/rankings/hillsborough/county/outc
omes/overall/snapshot
Erickson, C. (2012.) Biz Currents. Tampa Bays Largest Healthcare Systems. Retrieved March 9,
2016 from http://www.bizjournals.com/tampabay/blog/2012/08/top-7-of-the-list-largesthealthcare.html
Harris K, Holden C, Chen M. (2010). Healthy People 2020. Determinants of Health. Retrieved
March 9, 2016 from https://www.healthypeople.gov/2020/about/foundation-healthmeasures/Determinants-of-Health
Hillsborough County Atlas. (2012.) Florida Center for Community Design and Research, School
of Architecture and Community Design, University of South Florida. Retrieved March 9,
2016 from http://www.hillsborough.communityatlas.usf.edu/demographics/default.asp?
ID=12057
Key West Chamber of Commerce. (2010.) Largest Employers by County on the Florida
Suncoast. Retrieved March 9, 2016 from http://suncoastemployers.com/#hillsborough
United States Census Bureau. (2015.) Quick Facts Hillsborough County Florida. Retrieved
March 9, 2016 from http://www.census.gov/quickfacts/table/PST045215/12057

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